Child Trauma Network & the e-learning project EUMEDGRID-Support Kick-Off Meeting

1. Child Trauma Network& the e-learning project EUMEDGRID-Support Kick-Off Meeting Cairo 26 January 2010 Patricia Villavicencio Carrillo, Ph.D Unidad de Trauma Psíquico Hospital Clínico San Carlos. Madrid-Spain

2. Children represent the future, and ensuring their healthy growth and development ought to be a prime concern of all societies. • L’avenir de toutes les sociétés repose sur les enfants, dont il faut absolument assurer la santé, la croissance et le développement. http://www.who.int/topics/child_health/en/

3. From The Pain Come The Dream From The Dream Come The Vision From The Vision Come The People And From The People Come The Power From The Power Come The Change” “Fourteen black paintings” In: Peter Gabriel “US” (1992) Why Networking?

4. CHILD TRAUMA NETWORK brings together a group of experts in Child psychotramatology (psychiatrists and psychologists) initially 9 Euro-Mediterranean countries + 2 invited countries (Egypt and Palestine) in order to: Create a consulting and psychological support network among specialists in the field Compare knowledge and experience to improve the scientific field of child psychotraumatology Harmonize actions in different following phases: immediate, post- immediate and long term consequences WHAT IS CHILD TRAUMA NETWORK?

5. Identify and describe specific clinical profiles of reactions to stressful situations, Improve the examination guidelines and the evaluation scales, Recommend the most appropriate therapeutic interventions, and Reinforce the mutual collaboration,in the field of psychological support to children traumatized by disasters or war The partners of the CTN have always had present: The cultural particularities that influence the clinical expression of the suffering in traumatized children, such as self censure of the psychological suffering, the priority given to somatic complaints, etc. The traditional and cultural thinking and attitudes which can, in some countries, cause an inequality between boys and girls in accessing to the medical and psychological care. WHAT IS CHILD TRAUMA NETWORK?

6. Algeria: Pr. Farid KACHA, Hôpital Charaga, Alger Belgium: M. Etienne VERMEIREN, Hôpital Saint-Luc, Bruxelles France: Pr. Louis CROCQ, Hôpital Necker, Paris Italy: Dr. Roberto Marino, Center EOS, Pavia Lebanon: Pr. Myrna GANNAGE, University St-Joseph, Beyrouth Morocco: Pr. Kamal RADDAOUI, University of Rabat San Marino: Pr. Giovanni GALASSI, hospital of San Marino Spain: Pr. Juan-José LÓPEZ-IBOR, Hospital San Carlos, Madrid Tunisia: Pr. Daïda DOUKI, Pr. Asma BOUDEN, Hôpital Razi, Tunis Egypt: Dr. Heba HABIB, Palestine:, Dr Sylvie MANSOUR THE 9+2 EURO-MEDITERRANEAN COUNTRIES

7. All have interest on the clinical/therapeutic strategies and in the study of traumatized children by war, terrorism and disasters All of them have practical experience in this field (particularly terrorism in Algeria, Morocco, Lebanon, Egypt, France, and Spain, civil war in Lebanon and Palestine, and recent earthquakes in Algeria and Morocco) All speak French (at a first instance, as it is foreseen an extension of the network to English, Spanish and Arabic speaking countries) The Child Trauma Network received financial support from: the European Commission (VI Framework Programme: PL 509082) Spain. Solicitud de Ayudas de incentivación a la participación en Proyectos del Espacio Europeo de Investigación. Instituto Carlos III (A107/90047) WHY THESE PARTNERS ?

8. Time period: initially from 2005 to 2006, plus a 2 year extension: 2007-2008 The work done consists on: scientific exchanges by post or email, scientific meetings -with obligation to hold these meetings mainly in South-Mediterranean countries. Six meetings were held: 1 in Spain, 2 in Algeria, 2 in Tunisia, 1 in Lebanon, San Marino (administrative) and the last scientific meeting in Morocco. elaboration and edition of a practical handbook for training psychiatrists and psychologists to examine and treat traumatized children, The creation of a web-site www.childtraumanetwork.com for facilitating the communication between partners and for the diffusion of the network experience THE ACTIVITIES

9. Cooperative multicentre activities 1) Meetings and electronic exchanges have primarily: delimited the specific field of the study Shared and established a common bibliography described the clinical particularities of the traumatized children and adolescents, with focus on war, terrorism and disasters, and gender and cultural particularities The ICD-10 and the DSM-IV were the main scientific references were but also: Evidence based research studies on child psycho-traumatology, specific studies on populations victim of disasters, and civilian populations victims of war and terrorism. MAIN RESULTS: A) Common Research:Children psychotraumatized by war, terrorism or disaster

10. 2) established common guidelines for clinical examination of psychotraumatized children and adolescents, 3) Trained young psychiatrists and psychologists recruited in the 11 countries to use these guidelines, tests and scales Tested their application on traumatized children and adolescents MAIN RESULTS: B) Common tools:New tests and scales

11. Elaborated and written a common Handbook “MANUEL POUR L’EXAMEN ET LE TRAITEMENT DE L’ENFANT TRAUMATISE” Tested this handbook (first version) on young psychiatrists and psychologists, Rewritten the handbook (definitive text) after the remarks and critics of the young colleagues MAIN RESULTS: D) The Handbook

12. III - MAIN RESULTS: F) The web-site CHILD TRAUMA NETWORK www.childtraumanetwork.com

13. Child Trauma Network Web & e-learning project -1- • In addition to Child Trauma Nertwork’s proposed objectives the Spanish team designed a complementary project. • This project is known as the Child Trauma e-learning project . • Our main goals are: • to spread the knowledge captured in CTN intervention Handbook to a greater number of professionals interested in the field. • The improvement of the Child Trauma web page design, its applications and • The promotion of its utility to guarantee the project’s knowledge dissemination and the participation of mental health professionals in the future e-learning courses based primarily on the CTN Intervention Handbook. • The Web´s official language is French and Spanish to start with It is intended to obtain further grants to develop other versions in other languages : English, Arabic…..

14. Child Trauma Network Web & e-learning project -2- • The deployment of the Web may initiate substantial changes: • In the communications among CTN partners • In the organizations tasked to deal with contingencies during disasters´s crisis, wars, & massive violence, particularly in the field of child psychotraumatology.

15. Child Trauma Network Web & e-learning project -2- • The Web brings the advantage of a • more dynamic and • more concerted long term exchanges for the advancement of scientific knowledge and the improvement of methods of intervention in the child psychotraumatology field.

16. Child Trauma Network Web & e-learning project -4- • The Web also proportionate • E-mail and e-mail-based discussion groups • web-based forums; • e-discussions for individual and group Communications • in case of disasters, wars and/or massive violence

17. Multilingual (Spanish and French) e-learning courses are included in the Training section. • It is important to find innovative ways for training large numbers of professionals on the field of child psycho-traumatology • who have no means of attending or taking part in a presential training course

18. Interventions in disasters must be carried out by local professionals due to the reticence produced when a foreign professional attempts to intervene in the local population. • The CTN Web could avoid this difficulty by providing a interconsultancy system between local and foreign professionals and through e-learning training + presential for those local professionals.

19. Child Trauma Network Web & e-learning project -5- • There is a section of the web page which includes the Handbook’s content (french) • Available for the members of the CTN project and later on to Mental health Professionals contacting our network • The Spanish version will also be available soon.

20. Child Trauma Network Web & e-learning project -6- • The Web will not only allow the transmission of numeric and word data • but also pictures and short movies presenting the disaster's impact and intervention procedures

21. Child Trauma Network Web & e-learning project -7- • Moreover, the project’s web page would also serve as: • a source of support for those affected citizens, specially children and adolescents. • Youngsters will only have access to material designed exclusively for them

22. It is crucial to train on immediate interventions practices as well as on short and mid term interventions in order to prevent and recover the psycho-affective health in children who have been affected by important traumatic events Training in child psychotraumatology tends to be very limited, and when it actually takes place, it is often of a very short duration. Professionals tend to abandon the practice of new tools in evaluation and intervention and return to their old practices. Computer-mediated networking and communications, enabled by Internet technology, has opened a new window of opportunity for mental health professionals interested in getting access to specialized training in the field of child psychotraumatology. E-learning of training has shown to be highly efficient for training a large number of professionals on the disaster techniques and interventions (Bisson and Cohen, 2006; Saunders and Smith, 2005; Shmeeckle, 2000). Why e-learning in psychotraumatology? -1-

23. Why e-learning in psychotraumatology?-4- Being the main objective of “CTN” the creation of a inter-consultancy networkof mutual help in the field e-learning is the best solution for training professional teams that are geographically scattered around the world.

24. Why e-learning in psychotraumatology?-4- • Professionals have access to training through internet, reduces travel cost and time to and from school or long trips displacements. • The training is homogeneous for all participants.

25. Why e-learning in psychotraumatology? -5- 3. It could be offered as many “Training Calls” as desired; 4. the e-learning material will be always available.

26. How to access to the training material and e-learning? Didactical resources needed for experiencing a complete/total learning will be found in the computer screen. Exercises Practical Case Studies Situation scenarios On-line help material Evaluations

27. How to access to the training material and e-learning? Didactical resources needed for experiencing a complete/total learning will be found in the computer screen. Situation scenarios Practical Case Studies Exercises Evaluations On-line help material

28. The theoretical contents of the course, are contextualized inside a concrete scenario. Though his way professionals will have access to the knowledge required for intervening in a “realscenario“, similar to the one that they would find in a real life situation. Recursos Didácticos del curso. Escenografía

29. Recursos Didácticos del curso. Elementos Prácticos Among the theoretical contents, there will be inserted a diversity of exercises and/or practical cases that the user will have to solve. These practical elements will serve as learning reinforcement. At the end of the training, professionals will be able to discover which level learning they have reached through an on-line evaluation. After the evaluation, participants would be able to check their score and find out which answers have been right or wrong.

30. E-learning as an essential aspect of the CTN Project E-learning enables the development and the addition of small formative/training cells, clinical case studies, videoconferences, and other resources that will support for more specialized knowledge y All these resources may compound a “formative virtual campus” that will allow professionals to up date the knowledge in order to reach a higher specialization .

31. CHILD TRAUMA NETWORK is an example of international cooperation - theory and practice - in child psychotraumatology CTN carries out a permanent exchange of information, confronts different points of view and stimulates a collective reflection CTN establishes a common state of art on the question, defines specific profiles taking in account the intercultural and gender particularities The web-site:www.childtraumanetwork.com facilitates the communication between partners and is a great tool forthe diffusion of its experience. Conclusions

32. It is important to find innovative ways for training large numbers of professionals on the field of child psychotraumatology who have no means of attending or taking part in a presential training course The CTN web is a high technology tool which guarantees major dissemination of theintervention Handbook’s content through e-learning courses Our Web is a tool for research purposes, for example for the assessment of the efficacy of treatments or starting epidemiological studies in the field of child psychotraumatology especially in the countries that have not them yet. The proposed e-learning course, together with its supporting web-page proportionate a means of communication among professionals and general public which will help building a general conscientiousness on what can be done to relieve traumatic symptomatology. Conclusions

33. Conclusions • We hope that our initiative could encourage colleagues in other fields to collaborate with our project in order to assure the extension and the continuity. ¡Gracias! Thank you ! شكرا